Thyroxine replacement: a clinical endocrinologist’s viewpoint

Eligar, V; Taylor, PN; Okosieme, OE; Leese, GP; Dayan, CM

doi:10.1177/0004563216642255

Cited by 72Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

Thyroxine replacement: a clinical endocrinologist’s viewpoint

Eligar, V, Taylor, PN, Okosieme, OE, Leese, GP, Dayan, CM·2016·Annals of Clinical Biochemistry: International Journal of Laboratory Medicine

DOI 10.1177/0004563216642255

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Abstract

Background: Hypothyroidism affects 2–5% of the general population. Patients with uncorrected disease suffer significant morbidity and have an increased risk of cardiovascular disease and neurocognitive impairment. Levothyroxine, the treatment of choice, is inexpensive, easy to administer and in most cases restores well-being while normalizing thyroid function. However, 30–50% of individuals on levothyroxine are either over-treated or under-treated and others remain dissatisfied with treatment despite achieving thyroid hormone concentrations within the laboratory reference interval. Methods: This review is based on a systematic search of the literature for controlled trials, systematic reviews, guideline papers and cohort studies addressing best practice in thyroid hormone replacement. Results: Recent decades have seen improvements in patient management strategies driven by a better appreciation of levothyroxine pharmacokinetics. However, aspects of therapy such as the optimal timing of medication, strategies to overcome treatment non-adherence and target thyroid stimulating hormone concentrations in pregnancy and in patients with differentiated thyroid cancer remain challenging. Furthermore, there is now a substantial body of literature on common genetic variations in the deiodinases and thyroid hormone transporters and their role in the local regulation of thyroid hormone delivery. The benefits of combination therapy with liothyronine and levothyroxine are uncertain, and while it is theoretically probable that subsets of genetically predisposed individuals will benefit from combination therapy the existing evidence is as yet limited. Conclusion: Despite the availability of thyroid hormone replacement for more than a century, there are still substantial challenges in practice and opportunities to improve treatment outcomes.

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At therapeutic doses, levothyroxine is safe, well-tolerated, with rarely reported serious side effects.
“At therapeutic doses, levothyroxine is safe, well -tolerated, with rarely reported serious side effects. 67”
From Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement (2023) · cites this paper as [67]
Almost half of LT4-treated primary hypothyroid patients worldwide appear under- or over-treated when serum TSH is used as marker.
“Indeed, using serum TSH as a marker of adequate thyroid hormones status in LT4-treated primary hypothyroid patients, almost half of treated patients in the world appear to be under- or over-treated (2).”
From ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism (2025) · cites this paper as [2]
Observational studies of LT4-treated patients with hypothyroidism have demonstrated that almost half have serum TSH levels either low or high, indicative of over- or under-replacement.
“Observational studies of LT4-treated patients with hypothyroidism have demonstrated that almost half of the patients have serum TSH levels that are either low or high, indicative of over- or under-replacement (2).”
From ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism (2025) · cites this paper as [2]
The long-term safety of Liothyronine has not been established in children.
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From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [53]

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Hypothyroidism: Diversity of Presentation
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Thyroxine vs Thyroxine Plus Triiodothyronine in Treatment of Hypothyroidism After Thyroidectomy for Graves' Disease
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Whole-genome sequence-based analysis of thyroid function
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The Excess Risk of Major Osteoporotic Fractures in Hypothyroidism Is Driven by Cumulative Hyperthyroid as Opposed to Hypothyroid Time: An Observational Register-Based Time-Resolved Cohort Analysis
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Adequacy of thyroid hormone replacement in a general population
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Treatment of Hypothyroidism with Once Weekly Thyroxine1
Grebe, S. K. G., Cooke, R. R., Ford, H. C., Fagerström, J. N., Cordwell, D. P., Lever, N. A., Purdie, G., & Feek, C. M. (1997) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.82.3.3830 · Cited by 95 · see citing works
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Polymorphisms in type 2 deiodinase are not associated with well-being, neurocognitive functioning, and preference for combined thyroxine/3,5,3′-triiodothyronine therapy
Appelhof, B. C., Peeters, R. P., Wiersinga, W. M., Visser, T. J., Wekking, E. M., Huyser, J., Schene, A. H., Tijssen, J. G. P., Hoogendijk, W. J. G., & Fliers, E. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-0451 · Cited by 91 · see citing works
Hypothyroidism in Patients Older Than 55 Years: An Analysis of the Etiology and Assessment of the Effectiveness of Therapy
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<scp>l</scp>-Thyroxine Requirement in Patients with Autoimmune Hypothyroidism and Parietal Cell Antibodies
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Substitution of Liothyronine at a 1:5 Ratio for a Portion of Levothyroxine: Effect on Fatigue, Symptoms of Depression, and Working Memory Versus Treatment With Levothyroxine Alone
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Tyrosine kinase inhibitors and modifications of thyroid function tests: a review
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Subclinical hypothyroidism and cognitive function in people over 60 years: a systematic review and meta-analysis
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Trends in thyroid hormone prescribing and consumption in the UK
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Myxedema Coma
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Efficacy of Combined Levothyroxine and Liothyronine as Compared with Levothyroxine Monotherapy in Primary Hypothyroidism: A Randomized Controlled Trial
Valizadeh, M., Seyyed-Majidi, M. R., Hajibeigloo, H., Momtazi, S., Musavinasab, N., & Hayatbakhsh, M. R. (2009) · Endocrine Research · doi:10.1080/07435800903156340 · Cited by 65 · cited 1× · see citing works
“1:5 Parallel 94 No No No 52 29 NS Valizadeh et al.(99) Parallel 71 No Yes – – – – Saravanan et al.”
Background
How do you approach the problem of TSH elevation in a patient on high‐dose thyroid hormone replacement?
Morris, J. C. (2009) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2009.03536.x · Cited by 59 · see citing works
Treatment of clinical hypothyroidism with thyroxine and triiodothyronine: a literature review and metaanalysis
Joffe, R. T., Brimacombe, M., Levitt, A. J., & Stagnaro-Green, A. (2007) · Psychosomatics · doi:10.1176/appi.psy.48.5.379 · Cited by 57 · see citing works
Medical management of thyroid dysfunction in pregnancy and the postpartum
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Postpartum Thyroiditis
Lazarus, J. H., Parkes, A. B., & Premawardhana, L. D. K. E. (2002) · Autoimmunity · doi:10.1080/08916930290031667 · Cited by 56 · see citing works
In Search of the Impossible Dream? Thyroid Hormone Replacement Therapy That Treats All Symptoms in All Hypothyroid Patients
Kaplan, M. M., Sarne, D. H., & Schneider, A. B. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031436 · Cited by 50 · see citing works
How good is the levothyroxine replacement in primary hypothyroidism patients in Brazil? Data of a multicentre study
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Celiac Disease Presenting as Resistant Hypothyroidism
McDermott, J. H., Coss, A., & Walsh, C. H. (2005) · Thyroid · doi:10.1089/thy.2005.15.386 · Cited by 48 · see citing works
Prevalence of Parietal Cell Antibodies in a Large Cohort of Patients with Autoimmune Thyroiditis
Checchi, S., Montanaro, A., Ciuoli, C., Brusco, L., Pasqui, L., Fioravanti, C., Sestini, F., & Pacini, F. (2010) · Thyroid · doi:10.1089/thy.2010.0041 · Cited by 43 · see citing works
TSH-Based Protocol, Tablet Instability, and Absorption Effects on L-T 4 Bioequivalence
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Do not forget nephrotic syndrome as a cause of increased requirement of levothyroxine replacement therapy
Benvenga, S., Vita, R., Di Bari, F., Fallahi, P., & Antonelli, A. (2015) · European Thyroid Journal · doi:10.1159/000381310 · Cited by 37 · see citing works
Randomised controlled trial of a hypothyroid educational booklet to improve thyroxine adherence.
Crilly, M., & Esmail, A. (2005) · Europe PMC (PubMed Central) · Cited by 37 · see citing works
Thyroid hormone replacement: current status and challenges
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Clinically Inactive ThyroidU.S.P.
Catz, B., Ginsburg, E., & Salenger, S. (1962) · New England Journal of Medicine · doi:10.1056/nejm196201182660308 · Cited by 31 · see citing works
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Are patients with primary hypothyroidism in India receiving appropriate thyroxine replacement? An observational study
Mithal, A., Dharmalingam, M., & Tewari, N. (2014) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.126582 · Cited by 28 · see citing works
Treating primary hypothyroidism with weekly doses of levothyroxine: a randomized, single-blind, crossover study
Bornschein, A., Paz-Filho, G., Graf, H., & de Carvalho, G. A. (2012) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302012000400006 · Cited by 28 · see citing works
Estudo de adesão ao tratamento do hipotiroidismo
Bagattoli, R. M., Vaisman, M., Lima, J. S., & Ward, L. S. (2000) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302000000600006 · Cited by 25 · see citing works
Thyroid function tests in patients taking thyroid medication in Germany: Results from the population-based Study of Health in Pomerania (SHIP)
Hannemann, A., Friedrich, N., Haring, R., Krebs, A., Völzke, H., Alte, D., Nauck, M. A., Kohlmann, T., Schober, H., Hoffmann, W. U., et al. (2010) · BMC Research Notes · doi:10.1186/1756-0500-3-227 · Cited by 22 · see citing works
A comparison of thyroxine and desiccated thyroid in patients with primary hypothyroidism
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Determination of Thyroxine and Triiodothyronine in Commercial Preparations of Desiccated Thyroid and Thyroid Extract
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European Thyroid Association Guidelines on L-T4 + L-T3 Combination for Hypothyroidism: A Weary Step in the Right Direction
Perros, P. (2012) · European Thyroid Journal · doi:10.1159/000338637 · Cited by 20 · see citing works
The discovery of thyroid replacement therapy. Part 1: In the beginning
Slater, S. D. (2011) · Journal of the Royal Society of Medicine · doi:10.1258/jrsm.2010.10k050 · Cited by 20 · see citing works
Genetic abnormalities in thyroid hormone deiodinases
Taylor, P. N., Peeters, R. P., & Dayan, C. M. (2015) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000180 · Cited by 19 · see citing works
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Elevated Serum Concentrations of Triiodothyronine in Hypothyroid Patients
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Thyroxine adherence in primary hypothyroidism
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The discovery of thyroid replacement therapy. Part 2: The critical 19th century
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A Welsh-sparing dysphasia
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Self-citation
Patients on Appropriate T4Replacement Are as Content as They Would Be on Any Thyroid Hormone
Laurberg, P. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-032136 · Cited by 10 · see citing works
Changes in Serum TSH and T4 Levels after Switching the Levothyroxine Administration Time from before Breakfast to before Dinner
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The Invention of Thyroid Therapy in the Late Nineteenth Century
Sawin, C. T. (2001) · The Endocrinologist · doi:10.1097/00019616-200101000-00001 · Cited by 9 · see citing works

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Global epidemiology of hyperthyroidism and hypothyroidism
Taylor, P. N., Albrecht, D., Scholz, A., Gutierrez-Buey, G., Lazarus, J. H., Dayan, C. M., & Okosieme, O. E. (2018) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2018.18 · Cited by 1,552 · see citing works
Self-citation
Gastrointestinal malabsorption of thyroxine
Virili, C., Antonelli, A., Santaguida, M. G., Benvenga, S., & Centanni, M. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00168 · Cited by 164 · see citing works
Bioprinting of a functional vascularized mouse thyroid gland construct
Bulanova, E. A., Koudan, E. V., Degosserie, J., Heymans, C., Pereira, F. D. A. S., Parfenov, V. A., Sun, Y. N., Wang, Q., Akhmedova, S. A., Sviridova, I. K., et al. (2017) · Biofabrication · doi:10.1088/1758-5090/aa7fdd · Cited by 134 · see citing works
Thyroid hormone therapy for hypothyroidism
Biondi, B., & Cooper, D. S. (2019) · Endocrine · doi:10.1007/s12020-019-02023-7 · Cited by 110 · see citing works
Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice
Taylor, P. N., Lansdown, A., Witczak, J., Khan, R., Rees, A., Dayan, C. M., & Okosieme, O. (2023) · Thyroid Research · doi:10.1186/s13044-023-00149-5 · Cited by 72 · see citing works
“Unlike Levothyroxine which has extensive safety data the long-term safety of Liothyronine has not been established in children [53, 54].”
BackgroundSelf-citation
Levothyroxine therapy in gastric malabsorptive disorders
Virili, C., Brusca, N., Capriello, S., & Centanni, M. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.621616 · Cited by 52 · see citing works
Recent advances in biofabrication strategies based on bioprinting for vascularized tissue repair and regeneration
Xing, F., Xu, J., Yu, P., Zhou, Y., Zhe, M., Luo, R., Liu, M., Xiang, Z., Duan, X., & Ritz, U. (2023) · Materials & Design · doi:10.1016/j.matdes.2023.111885 · Cited by 46 · see citing works
Novel thyroxine formulations: a further step toward precision medicine
Virili, C., Trimboli, P., & Centanni, M. (2019) · Endocrine · doi:10.1007/s12020-019-02049-x · Cited by 41 · see citing works
Precision Medicine in Autoimmune Thyroiditis and Hypothyroidism
Ferrari, S. M., Ragusa, F., Elia, G., Paparo, S. R., Mazzi, V., Baldini, E., Benvenga, S., Antonelli, A., & Fallahi, P. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.750380 · Cited by 41 · see citing works
Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement
Ahluwalia, R., Baldeweg, S. E., Boelaert, K., Chatterjee, K., Dayan, C., Okosieme, O., Priestley, J., Taylor, P., Vaidya, B., Zammitt, N., et al. (2023) · Clinical Endocrinology · doi:10.1111/cen.14935 · Cited by 34 · see citing works
“At therapeutic doses, levothyroxine is safe, well‐tolerated, with rarely reported serious side effects.(67) Levothyroxine has a narrow therapeutic index, however, and both under‐treatment (TSH above the reference range) and over‐ treatment (TSH below the reference range) are common, with cross‐sectional studies consis…”
BackgroundSelf-citation
ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism
Centanni, M., Duntas, L., Feldt-Rasmussen, U., Koehrle, J., Peeters, R. P., Razvi, S., Trimboli, P., & Virili, C. (2025) · European Thyroid Journal · doi:10.1530/etj-25-0123 · Cited by 38 · see citing works
“Observational studies of LT4-treated patients with hypothyroidism have demonstrated that almost half of the patients have serum TSH levels that are either low or high, indicative of over-or under-replacement (2).”
The Stability of TSH, and Thyroid Hormones, in Patients Treated With Tablet, or Liquid Levo-Thyroxine
Antonelli, A., Elia, G., Ragusa, F., Paparo, S. R., Cavallini, G., Benvenga, S., Ferrari, S. M., & Fallahi, P. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.633587 · Cited by 32 · see citing works
The management and metabolic characterization: hyperthyroidism and hypothyroidism
Wang, Y., Sun, Y., Yang, B., Wang, Q., & Kuang, H. (2022) · Neuropeptides · doi:10.1016/j.npep.2022.102308 · Cited by 33 · see citing works
Advancements in biosensing of hormones: Recent progress and future trends
Behyar, M. B., Mirzaie, A., Hasanzadeh, M., & Shadjou, N. (2024) · TrAC Trends in Analytical Chemistry · doi:10.1016/j.trac.2024.117600 · Cited by 29 · see citing works
Neither Baseline nor Changes in Serum Triiodothyronine during Levothyroxine/Liothyronine Combination Therapy Predict a Positive Response to This Treatment Modality in Hypothyroid Patients with Persistent Symptoms
Medici, B. B., la Cour, J. L., Michaelsson, L. F., Faber, J. O., & Nygaard, B. (2017) · European Thyroid Journal · doi:10.1159/000454878 · Cited by 25 · see citing works
Prevalence of temporomandibular disorders in patients with Hashimoto thyroiditis
Grozdinska, A., Hofmann, E., Schmid, M., & Hirschfelder, U. (2018) · Journal of Orofacial Orthopedics-fortschritte Der Kieferorthopadie · doi:10.1007/s00056-018-0140-6 · Cited by 23 · see citing works
Levothyroxine treatment and gastric juice pH in humans: the proof of concept
Virili, C., Bruno, G., Santaguida, M. G., Gargano, L., Stramazzo, I., De Vito, C., Cicenia, A., Scalese, G., Porowska, B., Severi, C., et al. (2022) · Endocrine · doi:10.1007/s12020-022-03056-1 · Cited by 22 · see citing works
L-T4 Therapy in Enteric Malabsorptive Disorders
Fallahi, P., Ferrari, S. M., Elia, G., Ragusa, F., Paparo, S. R., & Antonelli, A. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.626371 · Cited by 23 · see citing works
Current challenges in the pharmacological management of thyroid dysfunction in pregnancy
Khan, I. N., Okosieme, O. E., & Lazarus, J. H. (2016) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2017.1253471 · Cited by 23 · see citing works
Self-citation
Combination Thyroid Hormone Replacement; Knowns and Unknowns
Taylor, P. N., Eligar, V. S., Muller, I., Scholz, A., Dayan, C. M., & Okosieme, O. E. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00706 · Cited by 21 · see citing works
Self-citation
Levothyroxine sodium pentahydrate tablets – formulation considerations
Kaur, N., & Suryanarayanan, R. (2021) · Journal of Pharmaceutical Sciences · doi:10.1016/j.xphs.2021.08.006 · Cited by 19 · see citing works
Molecular insights into binding mechanism of rutin to bovine serum albumin – Levothyroxine complex: Spectroscopic and molecular docking approaches
Sandu, N., Chilom, C. G., & Florescu, M. (2021) · Spectrochimica Acta Part A Molecular and Biomolecular Spectroscopy · doi:10.1016/j.saa.2021.120261 · Cited by 17 · see citing works
Cardiovascular and bone health outcomes in older people with subclinical hypothyroidism treated with levothyroxine: a systematic review and meta-analysis
Holley, M., Razvi, S., Farooq, M. S., Dew, R., Maxwell, I., & Wilkes, S. (2024) · Systematic Reviews · doi:10.1186/s13643-024-02548-7 · Cited by 17 · see citing works
Evaluation of anxiety and depression in patients with thyroid function disorder
Güneş, N. A. (2020) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.66.7.979 · Cited by 15 · see citing works
Potential of l -thyroxine to differentiate osteoblast-like cells via Angiopoietin1
Park, S., Lee, J., Kang, M., Moon, Y. J., Wang, S. I., Kim, K. M., Park, B., Jang, K. Y., & Kim, J. R. (2016) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2016.08.137 · Cited by 14 · see citing works
Diagnosis and treatment of hypothyroidism in old people
Borzì, A. M., Biondi, A., Basile, F., & Vacante, M. (2019) · Wiener klinische Wochenschrift · doi:10.1007/s00508-019-01579-8 · Cited by 14 · see citing works
Impact of fasting on thyrotropin and thyroid status during Ramadan in 292 previously well controlled hypothyroid patients. IFTAR study
Elsherbiny, T. M. (2022) · Endocrine · doi:10.1007/s12020-022-03242-1 · Cited by 13 · see citing works
Non-thionamide antithyroid drug options in Graves’ hyperthyroidism
Ruslan, A. M., & Okosieme, O. E. (2023) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2023.2167709 · Cited by 12 · see citing works
Self-citation
Pharmacokinetics and Clinical Implications of Two Non-Tablet Oral Formulations of L-Thyroxine in Patients with Hypothyroidism
Trimboli, P., & Mouly, S. J. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11123479 · Cited by 11 · see citing works
Getting the levothyroxine (LT4) dose right for adults with hypothyroidism: opportunities and challenges in the use of modern LT4 preparations
Gottwald‐Hostalek, U., & Razvi, S. (2022) · Current Medical Research and Opinion · doi:10.1080/03007995.2022.2071059 · Cited by 10 · see citing works
Editorial: Levothyroxine Therapy in Patients With Hypothyroidism
Antonelli, A., Wartofsky, L., & Miccoli, P. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.734895 · Cited by 8 · see citing works
Liothyronine for hypothyroidism: a candidate for disinvestment or in need of further research? A value of information analysis
Hughes, D. A., Skiadas, K., Fitzsimmons, D. F., Anderson, P., & Heald, A. H. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-051702 · Cited by 7 · see citing works
Adherence to levothyroxine treatment among patients with hypothyroidism in Oman: a national cross-sectional study
Kindi, R. M. A., Riyami, R. A. A., Juma, S. Y., & Kiyumi, M. I. A. (2023) · Current Medical Research and Opinion · doi:10.1080/03007995.2023.2250256 · Cited by 6 · see citing works
Over- and undertreatment with levothyroxine—findings of the population-based Rhineland Study
Alaeddin, N., Jongejan, R. M. S., Stingl, J., de Rijke, Y. B., Peeters, R. P., Breteler, M. M. B., & de Vries, F. M. (2023) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2023.0192 · Cited by 6 · see citing works
Decreased expression of ileal thyroid hormone transporters in a hypothyroid patient: a case report
Chung, C. W., Mo, E. Y., Jung, G. S., Kim, Y. H., Cho, S. W., Park, D. J., Bae, J. M., & Park, Y. J. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.664839 · Cited by 5 · see citing works
Italian guidelines for the management of adult individuals with primary hypothyroidism outside pregnancy
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Authors: Eligar, V, Taylor, P., Okosieme, O., Leese, G., & Dayan, C.
Affiliations: Cardiff University (GB)
Thyroid Research Group, Institute of Molecular and Experimental Medicine, School of Medicine, Cardiff University, Cardiff, UK
University of Dundee (GB)
ORCID: Eligar, V
Venue: Annals of Clinical Biochemistry: International Journal of Laboratory Medicine
Publisher: SAGE Publications
Published: 2016-04-28
Volume: 53
Issue: 4
Pages: 421-433
ISSN: 0004-5632 (ISSN-L)
1758-1001
DOI: 10.1177/0004563216642255
OpenAlex: W2345078908
Cited by: 72
References: 118
Citations by year: 2026: 5 · 2025: 9 · 2024: 9 · 2023: 13 · 2022: 9 · 2021: 11 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 2 · 2016: 2
FWCI: 0.54
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Annals of Clinical Biochemistry International Journal of Laboratory Medicine (publishedVersion)
PubMed (publishedVersion)
University of Birmingham Research Portal (University of Birmingham) (publishedVersion)
Discovery Research Portal (University of Dundee) (submittedVersion)
Funders: American Thyroid Association
Association for Clinical Biochemistry and Laboratory Medicine
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
Keywords: levothyroxine, hypothyroidism, thyroid hormone replacement, medication adherence, pregnancy, differentiated thyroid cancer, thyroid hormone transporters, overtreatment and undertreatment
MeSH terms: Endocrinologists, Animals, Humans, Hypothyroidism, Thyrotropin, Thyroxine, Randomized Controlled Trials as Topic, Hormone Replacement Therapy

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Thyroxine replacement: a clinical endocrinologist’s viewpoint

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